Anti-vax advocacy is unethical. Most of us are familiar with the reason: Withholding vaccines from your children doesn’t merely deprive them of protection and put them at risk for life threatening diseases. It deprives other people’s children of protection from those same diseases.

Vaccines work by making it impossible for pathogens to jump from person to person. Even the best vaccines are not 100% effective, and we can’t vaccinate 100% of the population. For example, babies can’t be vaccinated for specific diseases until they can mount the appropriate antibody response. Immuno-compromised people may not be able to mount an immune response at all.

Vaccines prevent the rise of superbugs.

If vaccines needed to be 100% effective to work, they wouldn’t work in the real world.

Instead, vaccines work by dramatically reducing the chance that an infected person will encounter an unprotected person. When parents withhold vaccines from their their children, herd immunity is disrupted and deadly diseases can spread. So when you refuse to vaccinate your own children, you aren’t just hurting them; you’re hurting many other.

Some of you are probably thinking “Big Deal! It’s my responsibility to protect my children from vaccine side effects and I have no responsibility to anyone else.” But you hurt everyone in another way that affects your children as well:

…Vaccines can reduce the prevalence of resistance by reducing the need for antimicrobial use and can reduce its impact by reducing the total number of cases… These effects may be amplified by herd immunity, extending protection to unvaccinated persons in the population. Because much selection for resistance is due to selection on bystander members of the normal flora, vaccination can reduce pressure for resistance even in pathogens not included in the vaccine…

Most anti-vax parents assume that if their unvaccinated child becomes ill with a vaccine preventable disease, they can take that child to the doctor’s office or hospital for antibiotics to cure the disease. Unfortunately, every time antibiotics are used, the risk of resistant superbugs grows. As Prof. Lipsitch points out, the microbes that become superbugs aren’t necessarily even the microbes that are causing the disease; they may be otherwise harmless bacteria in the normal microbiome.

For example:

Existing vaccines already help to reduce the burden of antimicrobial resistance. Notably, resistance is not a significant clinical problem for either of the transmissible bacterial infections against which we have routinely vaccinated for decades—diphtheria and pertussis, most likely because they are rarely seen and thus rarely treated…

But as parents continue to withhold vaccines from their children, the rate of rare diseases will inevitably rise and antibiotic resistance will rise along with it. And as Dr. Lipsitch notes, the new superbugs will not necessarily be those that cause diphtheria and pertussis; they might be staph bacteria that are normally present on the skin. Those staph bacteria commonly cause minor skin infections in cuts and scrapes but can quickly become lethal if they are resistant to antibiotics.

Lipsitch concludes:

Vaccines and antibiotics are widely hailed as the two greatest accomplishments of modern medicine. In fact, vaccines are the medical intervention that has saved the most lives globally. As evolution begins to erode the value of antibiotics, a multipronged approach to preserving and restoring this value is needed. Vaccines have an important role to play in doing so.

Both vaccines and antibiotics have saved millions of lives, but by overusing antibiotics we are destroying their usefulness and putting everyone at risk. Vaccines can reduce antibiotic resistance by preventing the need for antibiotics in the first place.

When parents withhold vaccines from their children under the assumption that they can be treated with antibiotics if they get sick, they don’t just hurt their children; they hurt everyone including themselves.

The thought of living in a post-antibiotic era frightens me so much that even when I’ve been prescribed antibiotics by the GP (and they don’t give them out like sweets to every whinger with a runny nose these days) I think “Do I REALLY need to take these, or would this ailment have gotten better on its own anyway?” I take them anyway, because Doctor’s Orders, but when I was given antibiotics because I developed a hematoma around my scar after my C-Section and I was told “This is to prevent the hematoma from becoming infected.” I thought “Really? We’re on the cusp of an apocalypse caused by the overuse of antibiotics and you’re telling me to take antibiotics (not just 1 mind, they had me on 2 together) to PREVENT the POSSIBILITY of an infection MAYBE occurring in the future? Why not just give kids a handful every day to stimulate growth like farmers do with livestock?”

Yes, I know that post-C-Section would have been a Very Bad Time to have bacteria floating around in my bloodstream; apparently a hematoma is a large pool of blood which might as well come with a flashing neon sign which says “Hey, Bacteria: Come and Scoff on This!” Thus the need to take preventative measures. But I was raised with the mentality that you don’t go to the GP/Minor Injuries Centre/A&E unless you really have to and if you DO decide you really need medical care you go to the first one on that list that can meet your needs (that is, you don’t go to A&E for an ear infection).

I put moaners with a cold insisting their GP give them a prescription for antibiotics in the same category as people going to A&E to get an aspirin for their mild headache, and I feel guilty whenever I take antibiotics or go to A&E but am not quite sure whether this course of action was justified. I would suggest putting anti-vaxxers who need antibiotics to treat VPDs they catch in the same category as adrenaline addicts who need to go to A&E as a result of their latest idiotic stunt, but that wouldn’t be fair on the adrenaline addicts who at least get some benefit from their antics.

N

The funny thing is, that those people I know avoid vaccines, also avoid antibiotics. They only go to their homeopathic doctor to get some globuli, treat ear infections and coughs with hot onions… I am not against all this and tried it out too, but if my pediatrician tells me my kids need antibiotics I believe him that they do. As for us adults, it is true, no need to go see a doctor for everything. As we say around here, colds stay for 7 days without medication and for a week with medication.

Charybdis

Aye, but here’s the rub; a lot of VPD’s are viral (measles, mumps, rubella, HPV, chickenpox, Hep A&B, and influenza), so antibiotics would not help with them anyway. Anyone who insists on getting antibiotics for those is Not Helping.

Prophylactic antibiotics does have a proper place and usage. I take antibiotics for 3 days after I get my IUD changed, my Dad had to have antibiotics for every dental procedure he had, including cleanings, because he had a pacemaker. I would also point out that those people who stop taking their antibiotic/s before the course is finished are also contributing the antibiotic resistance issue.

guest

Yeah, I had prophylactic antibiotics to have a tooth pulled, and that’s entirely reasonable even though I was not (as far as anyone knew) suffering from infection. Dentists also want patients with a heart murmur to take abx before any procedures. I used to have one, and also used to refused to take the abx because I didn’t understand how that could possibly be associated. (At some point I got a good explanation – this was a long time ago, and I no longer have a murmur).

MaineJen

You don’t have to feel guilty for taking prescribed antibiotics; you just have to take them as directed and finish the whole prescription. I think it’s appropriate to take them to prevent infection if you’re in a dangerous place (eg postpartum or immunosuppressed). I agree, they aren’t just prescribed willy-nilly any longer.

Who?

I will look into it and let you know

Charybdis

Oh, thank you!

N

Hi everyone,

This is OT, sorry for that:
Here is something to cheer you up a bit, after this whole Anna Fish thing:
More than a year ago, I tried to argue with all of you too, that breastfeeding/AP/co-sleeping/LLL isn’t that bad. That there are benefits etc etc… But your arguments where better than mine, as a lot of you are able to not only read but also understand scientific research and statistics. I can’t do it and am only repeating, what I hear/read/am told.

So I stopped writing, but came back regularly to read. To learn. And here is where I am now: I guess I will stay some kind of lactivist, and will continue to believe in the liquid gold thingy… because it worked for me, for us as a family. If ever I would have had to pump on a crazy exhausting schedule, if I listen deep down into myself, I must admit, that I don’t know for sure if I would have done it. If I would not have switched to combo feeding or formula only, like every sane person should do. It is far more important to be healthy and enjoy the baby!

I sincerely hope that in real life I have never and will never shame anybody because of a bottle, because of the way they are feeding their baby!!! I will definitly keep in mind, that there are many, many, MANY reasons, why breastfeeding is not mend for every woman, not the one and only golden standard for everyone.

And: In fact you are right: Don’t know for all the other lactivists but at least I can not tell which kids where breastfed and which formula fed in my kids classes. Well, I could try and guess which kids could read 100 and more books on their one or with their parents, and which would have read not even one book at the end of a schoolyear, according to what my kids tell me at home about their schoolmates. But even that would be only guessed and far from 100% right. But which milk did they get as babies? Can’t tell… honestly…

And as for the other things treated on this blog:

Birth: My kids are C-Section-kids. And I learned here that there really is nothing to regret about that. At least they where always save! So finally I am at peace with their way to enter this world. Thanks to all of you.

Vaccines: We are all fully vaccinated and up to date. I’m much more afraid about my kids being ill than about possible far fetched damages from the vaccines. Because even if I have not “done my research” properly on that subject, I am under the vague impression, that every problem one can encounter in ones live, can be related to vaccines, which seems a bit easy. Lets stop than all the vaccines and see if Autism/Hyperactivity/Cancer/Allergies/whatever-one-can-imagine miraculosly disapears.

Thanks to all of you for sharing your stories.

demodocus

Seems to me you are becoming a breastfeeding advocate, rather than lactivist. Hooray! We like advocates.

guest

This.

KeeperOfTheBooks

You know, as I grow as a mom, I’ve found myself feeling less like an activist for *insert parenting choice here* and more a “momivist.” This is true of most of my mom friends, too, I think. Some of us breastfeed; others FF or combo-feed. Some use cloth diapers, others disposables, some both. Etc. But when it comes down to it, we don’t care how the other moms parent beyond hoping it works well for them and their kids.
After I had DS, one of the (breastfeeding) neighborhood moms picked up some medication for me, and when she dropped it on my porch, she sent me this text: “I didn’t want you to feel like you had to get dressed or anything, so I left the meds by your front door. Also, I think I remember you use generic Enfamil. I had some left over from Baby Boy before I started exclusively breastfeeding, and it isn’t expired, so I put it by the meds. Let me know if you need anything else!” By “some,” she meant “a month’s supply in unopened containers.” 0_o
Similarly, when she had the day from hell a couple of weeks ago (stuck at home with a toddler and preschooler when the water heater gave out and flooded her ground floor, with a broken washing machine for good measure), another mom came by to pick up the kids and bring them to her house for a day-long playdate, while I brought over two days’ worth of kid-friendly, homemade freezer dinners.
Momivism FTW, I say!

The Bofa on the Sofa

You know, as I grow as a mom, I’ve found myself feeling less like an activist for *insert parenting choice here* and more a “momivist.” This is true of most of my mom friends, too, I think

It makes sense. As your kids grow, you realize far more about the shit that matters and the shit that doesn’t. And when your kid gets on the bus to head to kindergarten when they are 5, you aren’t think “Boy, I’m glad he was breastfed” or “I’m happy he wasn’t a c-section.” Personally, I was thinking, “Is he going to like the cafeteria lunches?” and “Who are his new friends going to be?”

As your kids grow, you grow with them, and your perspective changes.

Dr Amy’s advice: “1) Don’t sweat the small stuff, and 2) Most of it is small stuff” starts to be a lot more clear. When you’ve been through big things, it’s a lot easier to see the other stuff as small.

N

You are right, as our kids enter school, no one is interested anymore in how they were fed or which diapers they had, etc. And my thoughts every year when school starts is “I hope they will be ok/have nice teachers/cope with the teachers they have/don’t get mobbed/finf friends/not be too tired/…” And nothing related to their baby/toddler-years.

Wren

Yep. About the only time I think about the choices I made about how they were fed, diapers, etc. is when I talk to a friend who has a tiny one or is pregnant and when I’m here. When I’m with my kids, I’m far more interested in who they are now than what I did 8+ years ago with them.

Yup. The best thing I’ve ever seen re: parenting advice (not that I’m qualified in any way, shape or form) was something along the following lines.

“Parents, you can’t protect your children from the consequences of their mistakes ever. Sooner or later, your children will make bad choices and have unpleasant consequences. One way or the another, they will learn a hard lesson about thinking first then acting.

It’s not whether or not they will – it is a question of timing.

Would you rather they learn this lesson:

A)At EIGHT years old when they have a sore stomach and maybe arebeing sick from eating too much at once. It sounds uncomfortable until you consider the alternative which is:

or

B)At eightTEEN years old when they are away from home from the first time and they’re not entirely sober and there’s a handsome-charming-irresponsible lad saying “Oh, go on.”

Mariana

And that’s why I let my kids climb to the top of the climbing gym (or the tree), as long as they can climb by themselves. My friends think I’m crazy, they might fall and break something. I agree that a broken arm is really painful, but I need them to learn to asses risks and think before they act, and climbing at monkey bars serves the purpose when they are little. I’d rather they start considering what risks they can and can’t take now than when they are 18.

N

On playing parks my kids like to climb on everything too. Climbing and jumping down. I can not look at what they do, but I let them do anyway. Sometimes they ask me: can I jump down from up here? I would like to scream: Hell no! Are you crazy or what? Do you want to kill yourself? But I bite my tongue and say: You are there, it is up to you to decide if you can make it or not. I can not decide this for you. … Sometimes they jump and nothing happens and sometimes they don’t. If I would say hell no etc. at least our big one would jump just to make me crazy, and that would be far more dangerous…

demodocus

I’m still wondering where the line is. Boyo is not quite 3 and I’m just getting to this point, but he’s been climbing on playground equipment for over a year and he was trying to exit through things other than the slide and stairs when he was only 18 months old.

N

Yes, my almost 2 years old climbs on everything too. And I am very often very close to panic, with the things he does. I don’t remember anymore how it was exactly with the other two. But I think, as soon as they are able to talk, to understand, I grow more and more to just letting them do.

demodocus

he really did get a broken leg. my PPD is mostly depression, but the playground and the trains going by set off my anxiety

Yep. This is why my parents let me drink alcohol when I was a young ‘un.

The idea being that it was better I drank where it could be monitored then go mad and try everything once I hit 18 – legal drinking age here.

N

Yeah, Momivism sounds great. It must be nice to live where you live. Things like that would never happen here in our neighborhood.

KeeperOfTheBooks

It’s not quite utopia, but there is a really good group of people here. I’m very lucky.

KeeperOfTheBooks

OT: this is…interesting. Apologies in advance for the length.
After DS arrived, I got a Press-Ganey survey from the hospital about my experience. I filled it out honestly: excellent PPD support, kind nurses and techs, awesome OB, but exclusive rooming in sucked, and was really irresponsible given my condition. (I was hallucinating at one point, but if my best friend hadn’t been there, I’d have been expected to still take solo care of DS.) I left my name and contact info in the optional field so that if they had any questions, they could contact me.
About a month ago, I got a call from their marketing department. They wanted to discuss what I’d written on the survey. I explained, gave more details, etc. The guy I was talking to then explained that their board of directors is meeting next month, and they want to use people like me, who responded to the survey with detailed info, to appear in a film to talk about our experiences and how they were good, but also how they could have been improved. *jaw drops*
Well, who am I to argue if they actually want to listen to their patients? I said sure, and set a date. He called back a few days before to remind me of the appointment, to give me very precise directions and contact info, and to say, “Oh, by the way, I know you said you have childcare lined up, but just in case it falls through, we’ll have someone here to watch your kids if you need to bring them. Please don’t let that keep you from coming.”
Went in. Did the filming. I could be wrong, but I think that Something Is Up about that hospital’s BFHI status. I’m thinking there may either be massive physician or patient pushback, or perhaps a lawsuit in the works, or just plain some people in administration with hearts and/or brains (yeah, yeah, I know) who realize that it’s bloody cruel and stupid to expect all immediate postpartum moms to assume full, solo responsibility for their newborns’ care immediately after birth. Maybe a combination of the above.
The interviewer was very kind, and a very good listener. She didn’t really lead me at all. However, at one point, she dropped a very specific phrase relating to the BFHI status that I hadn’t used myself: “How would you say that having your baby in your room for a minimum of 23 hours per day affected you?” I didn’t mention the 23 hours/day thing, not in the survey, in the follow-up call, or that interview. Someone, somewhere has said that it’s a really stupid idea for some reason or other, and people are listening. I’d say that the interview was spent about a 20/80 positive/negative experience focus.
Perhaps it won’t make a difference. On the other hand, at the least it’s put a bug in some peoples’ ears. I was courteous and polite but also very honest in the interview. I was also able to discuss the rabid lactivism present two years ago, but less in evidence at my recent delivery, and I could see the interviewer looking utterly horrified when I described a) that I had been encourage to bedshare while nursing (complete with baby lying on a pillow under a blanket next to an overweight mom on narcotics) and b) the hallucinating situation.

Irène Delse

That’s interesting. Fingers crossed for the outcome!

D/

Polite, but honest responses with a focus on safety concerns and patient satisfaction (in that order) will *absolutely* grab the attention of decision makers. Getting both of those things right is what butters a hospital’s fiscal bread. The more similarly concerned responses, the more decision makers are likely to be influenced.

Thanks for doing this! 🙂

KeeperOfTheBooks

Believe me, I was delighted to do it. I also have to say that I appreciate that the hospital cared enough to ask me about my experience to this level of detail.

Another annoying truth about bacterial infections that we vaccinate for: it’s not so much about the actual bacteria itself as the toxins it produces that fucks with your kid.

Tetanus – that one produces so much toxin from so little bacteria that someone who survives lockjaw still needs to be vaccinated because the body can’t mount an immune reaction against the bacteria. Also – and I know I’m preaching to the choir – C. tetani is endemic in soil around the world. You can be Will Smith in “I am Legend” and still die from tetanus.

Diphtheria – the bacteria is easily killed. The thing that turns your trachea into a leathery membrane that can choke you to death – that would be the toxin again! We have anti-toxin, but it only works on free toxins that are not bound to cells. The toxin that’s tanning your throat cells into leather – we just have to wait for those to die.

Roadstergal

For all that the Alternative set rant about ‘toxins,’ the idea of actually protecting their babies against actual toxins doesn’t really seem to resonate with them.

Well, Roasdstergal, you have artificial toxins and natural toxins. Everyone knows that natural is good for you – totes!- so we should celebrate bacterial toxins…

Empliau

Botox ftw!

MaineJen

Scarlet fever rash = toxins released from the killed bacteria. Just little fun facts you pick up along the way…

Cody

My husband came home from work yesterday and said “hey I talked to my boss and he says you aren’t supposed to have caffeine and that we should use a delayed vaccination schedule?” This was phrased like a question to me because I’m pregnant.

I shut that shit down pretty quickly. Why do people think that this is their business? I can’t wait to hear the rest of his advice as the pregnancy progresses.

BeatriceC

Sounds like your husband need to learn how to say “My wife, her doctors and I have this covered”, and shut down the conversation.

LaMont

Oooh but to hear all the juicy crap the enemy camp truly thinks, you want to perfect the “how interesting, do go on” look 🙂

Yeah, but at some point your blood pressure is going to go up from hearing all of the nonsense. I had to leave a small playground earlier than I would have liked because this woman kept going ON AND ON (in a very loud voice) about natural remedies and the evils of Western medicine and how it’s screwing up our kids. Eventually, it just got to be too much, though I tried not to listen.

Roadstergal

My bosses are all various flavors of clinicians and immunologists. The bullshit I get is lower than usual, I think (although, sadly, not 0).

The right response seems to be “The expert panels at the CDC say we should use their schedule, and I’m going with them.”

Cody

I think my husband is more likely to go with the smile and nod. I also suspect that based on my response, he will no longer bother to tell me what his boss thinks.

niteseer

With my last child, I eschewed all caffeine……..at great personal distress! No one was a greater Coke addict than me. Walking past Coke vending machines was agonizing. Then, he was born with ADHD and on the autism spectrum, and was put on stimulant medications. I said……half seriously…….that maybe he’d have been better off with the prenatal caffeine, as the earliest intervention.

demodocus

coke addict?

niteseer

Let me clarify………Coca Cola, the soda, addict . *S* I guess if anyone is not familiar with the soft drink brand, it could cause confusion. No other substance vices than that one, luckily.

Whenever people give me unasked for advice, I smile brightly and respond that I have a good relationship with my OB (or pediatrician which is a lie now, but will be true eventually) and that I trust their advice.

For delayed vaccinations, I reply that my brother died from a birth defect that caused a bacterial infection from a mean bacteria that we currently have a vaccine for. My OB and pediatrician check the baby out to see if they have a spleen and I vaccinate them as soon as they are old enough because having a baby die is a tragedy that I don’t want to go through as a parent.

If they don’t respond to “no, seriously, my kid brother died of that shit and I’ll be damned if it happens on my watch”, with at least an embarrassed shrug and quick convo change, then I am dealing with a lunatic and should detach as quickly as possible.

The Bofa on the Sofa

Whenever people give me unasked for advice, I smile brightly and respond that I have a good relationship with my OB (or pediatrician which is a lie now, but will be true eventually) and that I trust their advice.

You would think that would be enough, and for most people, it is, but then there are the Anna Perch’s of the world who will just tell you that doctors are don’t know what they are talking about. Oh, she’s not suggesting that you don’t follow the doctor’s advice, just that the doctor is ignorant.

Irène Delse

Similar thing with a certain type of overzealous vegan. I don’t eat much meat to begin with, but as I explain when someone tries to push me towards a totally meat-free diet, I have anemia, and I trust my doctor’s and dietician’s advice to eat at least some meat, fish or egg, because i need the iron. At that point, some of them still try to tell me to disregard what the doctor says, because “they want you to be sick”. The first time this happened, I was just flabbergasted: that person knows nothing of me or my doctor, but they presume to tell me that?! It’s just so unreasonable.

Cody

Measles almost killed my mother when she was a child. Her parents and doctors thought she was going to die. As an adult it was discovered that she has a lot of scarring on her brain and we think that’s what it’s from.

The smile and nod is one of the skills that I try to impart on all new parents. When that fails, there is always the middle finger.

J.B.

Eyeroll.

When pregnant with my first I tried so hard to limit caffeine. Second time around, working? Phshaw!

Roadstergal

My mom gave up smoking and drinking when she decided to have kids. You have to leave her _something_!

Charybdis

I occasionally hate read a certain lactivist’s page. This is what I saw on there today…

Should mothers who smoke breastfeed?
“Mothers who smoke are encouraged to quit, however, breast milk remains the ideal food for a baby even if the mother smokes. Although nicotine may be present in breast milk, adverse effects on the infant during breastfeeding have not been reported. AAP recognizes pregnancy and lactation as two ideal times to promote smoking cessation, but does not indicate that mothers who smoke should not breastfeed.”
{CDC-http://www.cdc.gov/breastfeeding/faq/}

And this gem:

Every now and then I’ll see the “anti-lactavists” types who state that the benefits of breastfeeding are trivial if you live in a developed country and that it only really matters what you feed your baby if your live in a developing country. This is 100% simply just not true. Here is more evidence to show this…
“For every 597 women who optimally breastfeed, one maternal or child death is prevented. Policies to increase optimal breastfeeding could result in substantial public health gains. Breastfeeding has a larger impact on women’s health than previously appreciated.”https://www.ncbi.nlm.nih.gov/m/pubmed/27647492/

I’ve read this study. Basically, the author’s analysis takes a bunch of dodgy conclusions from other studies, aggregates them, and then announces that suboptimal breastfeeding is killing us/costing us lots of money in health care. Buried in there is an admission that causality hasn’t been proven for, like, ALL of these outcomes, which in my opinion is enough that this paper should never have been published.

Amy Tuteur, MD

This one is a new study from Bartick using a Monte-Carlo simulation to model risks from not breastfeeding.

There are two problems with it. Like any simulation, a Monte-Carlo simulation depends on the inputs. Bartick uses assumptions that are unproven in her simulation.

Second, we don’t really have to simulate the impact of increased breastfeeding. We’ve witnessed the impact of increased breastfeeding in the past 40 years. For term infants, there has been no impact.

Heidi_storage

Okay, yeah, I was thinking that this was the 2013 Obstet Gynecol study. Same tune out of the jukebox, though.

Cody

I don’t have that much to begin with so haven’t even thought about it.

Azuran

I was planning on limiting a little bit, since I was anywhere between 2 very huge cup a day on my days off and 4-6 on working days.
My morning sickness decided otherwise ¬_¬

An Actual Attorney

My old boss tried to tell me not to vaccinate my first. I told him very clearly and dryly that for the sake of our relationship, I was terminating the conversation immediately and walked out of his office. He was a great boss, possibly the best I’ll ever have, but he has some whacky conspiracy ideas. He’s also a 9/11 truther.

corblimeybot

My family still acts like it was sketchy that I kept drinking coffee during pregnancy. Never mind that my high-risk obs said it was fine. Never mind that their prescription for my occasional pregnancy migraine was a cup of coffee and a Tylenol (which worked insanely well).

BeatriceC

The hospital where I basically moved into while I was pregnant with my youngest actually served me coffee several times a day.

corblimeybot

HELL YEAH.

Sarah

Seems to be an American thing. I don’t like coffee, so it wasn’t immediately relevant to me, but NHS guidance was that 200mg a day is fine- two cups of instant. I don’t recall much angst about it.

Inmara

That’s what I found in almighty internetz as well, and tried to stick to (at least during second and third trimester, as during the first I was not interested in coffee at all). According to what Science Of Mom has written about existing research on coffee, pregnancy and breastfeeding, it’s plausible that coffee during pregnancy may desensitize baby to caffeine, so you can drink some while breastfeeding without getting any noticeable effect on baby’s sleep.

AnnaPDE

Yep, I never got any anti-coffee message here in Brisbane, at least while pregnant. I had the usual 2 cups per day, plus tea, and was offered both in hospital too. Only when I was struggling to get my milk supply up later on was I told to cut back on the caffeine, which made me grumpy for a few days and had exactly zero effect on the baby.

An Actual Attorney

I drink 10 or more cups a day, so pretty much every medical professional tells me to cut back, always.

BeatriceC

This is me. Plus Diet Coke. I drink an extremely unhealthy amount of caffeine. That said, my first clue that I was pregnant was a sudden and severe aversion to coffee. I couldn’t even have the grounds or beans in the house without wanting to hurl.

Who?

Coffee seems to run in people’s veins here in Brisbane. I don’t much care for it, and so don’t drink it, which is a cause of some surprise in many circles.

Mishimoo

Starbucks has this amazing Caramel Hazelnut Mocha right now, so if you head into the CBD, grab one while you’re there.

I asked for coffee with my first proper meal after my kids were born and actually had to argue to receive it, Mentioning that I need it because it stops my blood pressure dropping + dizziness when going from lying to sitting and sitting to standing (and the risk of having a baby in my arms if that happened) is how I finally got through to them.

AnnaPDE

Ha, thanks for the heads-up, I might just grab one when I visit the guys at the office. One of the few parts of pregnancy that I miss is being able to smell the scent of coffee and cake outside the Starbucks on Adelaide St, even in peak traffic.

corblimeybot

I think it IS an American thing. It’s part of the American version of the pregnancy-policing culture. So many little rules to follow, or you’re a terrible mother-to-be.

KeeperOfTheBooks

And many of the rules have more to do with the food-as-morality thing than anything else. For example, a pregnant friend of mine was once told off by a total stranger for having a latte and a (hot) ham sandwich for lunch. I have no doubt whatsoever that if she’d been eating a spinach salad with a glass of water and some cantaloupe for dessert, this person would have said nothing whatsoever, even though she’d be rather more likely to contract listeria or e. coli from the spinach and melon. Why? Because coffee and ham and cheese are Bad Foods, while spinach and fruit are Good Foods.
To me, it’s the modern version of shaming women for extramarital sex, never mind the actual circumstances and whether it was consensual or not. (Not, of course, that it’s appropriate to do so anyhow, or that it doesn’t happen sometimes even today.)

AA

CANTALOPE? Sorry but you should know you should eliminate sugar while pregnant. Do your research. /sarcasm

Sarah

You should eliminate everything when you’re pregnant, just to be sure. Even water. After all, too much of it will kill you. Better to be safe than sorry!

KeeperOfTheBooks

Oh, silly me…

Wren

It might well be. I was pregnant in the UK, but spent a couple of weeks in the US both times. I experienced more strangers telling me I should not be eating or drinking something during those weeks in the US than the rest of my pregnancies.

Tori

I stopped coffee during pregnancy. I stopped before that IVF round actually. In hindsight I could have had the coffee, and may have helped that first trimester fatigue!

Heidi

I don’t think anyone I knew found it sketchy, but when I was first pregnant, thanks to morning sickness, I abstained from coffee. My in-laws misinterpreted that and we had to go visit them while I was at the end of my 2nd trimester and well beyond puking all the time. They had bought a can of decaf coffee just for ME and my MIL insisted my husband drink it, too, in solidarity. Since the circumstances of our visit involved a lot of no sleep, my husband told her she’d make us a pot of real coffee or we were headed to McDonald’s for a cup.

demodocus

That was sweet if oblivious.

corblimeybot

Ha ha, that’s exactly what I was going to say.

CSN0116

I live on coffee and nearly always have a cup in my hand. My pregnancies were no different. I remember two female students giggling and mumbling back and forth to each other as I entered class one day when I was about 7 months pregnant with my fourth child. I asked them if they had something they wanted to ask me. They got red and embarrassed and said that they didn’t want to offend me but wanted to know why I drank coffee while pregnant — that their various college courses had taught them that pregnant women shouldn’t drink coffee as it risks stillbirth (?!). I explained to them that I already had three alive and well-adjusted children despite my indiscretions; that they were ill-informed; and that it was better to have my coffee than become a homicidal nasty-grader 😉

CSN0116

…I also consume (small amounts of) alcohol while pregnant, which is the utmost taboo in the US.

demodocus

egad, i couldn’t even be at the same table where other people were drinking alcohol even in my 3rd trimester. That and mushrooms; still can’t stand mushrooms. Pregnancy is weird.

Sarah

I was the same with alcohol, especially in my first pregnancy. The mere thought had me heaving. But I think it makes sense- it’s strong smelling, often quite pungent. Pregnant women have issues with smells!

Wren

Mine was coffee. And mint. I made my husband use some crazy kids mouthwash so he didn’t smell of mint after brushing his teeth and coffee was banned from the house both times.

While it may be off limits worldwide, I have always been of the understanding that it had varying levels of social acceptance amongst cultures.

Sonja Henie

Maybe, but so what? No country recommends drinking during pregnancy. From what I’ve read, it’s becoming less acceptable everywhere.

CSN0116

Always a pleasure, Sonja 😉

Sonja Henie

Whatever.

Sarah

Stunning argument there, genius.

Azuran

A lot of country are recommending pregnant women avoid an ever increasing ridiculous list of things. Basically the norm is: If it has any risk of being dangerous is any kind of way, you should have absolutely 0 of it, just in case, even if no harm was aver found or you need a large amount of it to cause damage.
Of course they are not going to ‘recommend’ drinking. But a few glasses of something here and there during pregnancy are not going to cause any damage. A lot of people will drink a little bit before they learn that they are pregnant. And their babies turn out just fine. Nobody is advocating for excessive dangerous behaviour, but society is just so obsessed with what pregnant women should and shouldn’t do.
I ate a few strawberries and raspberry out of my garden without washing them. I also ate a few fine cheese I apparently wasn’t supposed to eat because raw milk or something. I take long hot baths after a hard day of work to soothe by back and leg pain.
All things that are not ‘recommended’ during pregnancy.

Sonja Henie

“But a few glasses of something here and there during pregnancy are not going to cause any damage. A lot of people will drink a little bit before they learn that they are pregnant. And their babies turn out just fine. ”

What are your credentials for saying this? There is no safe level of alcohol intake in pregnancy. And not all the babies turn out “fine”. FAS was first identified in France, where I’ve read its now quite “outre” to drink while pregnant.

Wren

I have never seen evidence that a glass here and there over the entire pregnancy leads to FAS. Even in France women can be alcoholics and drink a whole lot more than that.

Sonja Henie

Depends on what “here and there” is. That one of the problems with the whole alcohol issue.

Wren

You seemed to be saying that it mattered that in France it is “outre” to drink while pregnant, as though French culture is somehow meaningful to how everyone else should behave.

The recommendations here in the UK are still to avoid alcohol, but they have added that if a pregnant woman decides to drink she should stick to small amounts. This is a change since 10 years ago, and one I appreciate as it actually treats pregnant women like adults with brains, gives them information and allows them to make an informed decision.

I do not believe any cases have been found in which 1-2 glasses of alcohol consumed in pregnancy have led to FAS.

Full disclosure: I had a glass of champagne at my sister’s wedding the day I hit 20 weeks with my son and half a glass at 7 weeks to toast our wedding anniversary with my daughter. I also sometimes had a drink or two during the nearly 4 years combined that I was breastfeeding.

Wren

Just for the record, that half a glass of champagne was encouraged by a consultant. I had been hospitalised for 4 days with food poisoning plus morning sickness and missed both Christmas celebrations and our anniversary. She specifically said a glass of champagne could not hurt me or the baby and I should have that bit of the celebrations. I still only managed half a glass.

Irène Delse

I bet if there ever was a documented case of FAS from half a glass of champagne, Sonja would have brought it up. Basically, she has nothing.

Wren

Given that alcohol use in pregnancy is almost always based on self-reporting and drinking in pregnancy has been frowned upon for quite some time now, I would struggle to believe a case like that even if I came across one.

That daughter is now 9, plays on 2 football teams, competes in gymnastics, swims, and is in the top set in school. I’m pretty darned sure the champagne didn’t hurt, though she is comparatively smaller than her brother (50th %ile in height rather than his 90th).

Irène Delse

I bet she brought up France because of the wine clichés. :-/
In reality, doctors here have been telling women to stop drinking during pregnancy since the 1980s at least. But then, as in any country, you have people who can’t or won’t do what’s best for them and their baby.

Sonja Henie

Wow! Talk about taking something and running with it. Peple always bring up France and the French drinking traditions when they talk about FAS, forgetting that FAS was first identified in France. They have since changed their culture around drinking in pregnancy from what I have read.

The UK and Ireland are the only countries in the world who discuss how much one could drink during pregnancy. Every other country simply says “just say no”.

And the reason the UK says what it does is that there is no evidence that light, occasional drinking in pregnancy causes a problem. The “just say no” approach is based more on a belief that pregnant women cannot reasonably be expected to limit their drinking if they are told any amount, however small, has not been shown to cause harm. The UK recently decided to start treating pregnant women as adults, informing them of the known risks and allowing them to behave like adults and determine the risk they are willing to take. Many still follow the better safe than sorry approach and have none (or don’t drink in the first place). Some choose light, occasional drinking. Those who choose more were ignoring the advice against drinking in the first place.

Sonja Henie

You do not seem to really understand what the UK did when it changed its recommendations. It actually made the recommendations stricter.http://www.bbc.com/news/uk-35252650
“But the new guidelines for pregnant women have now been updated in England, Wales and Northern Ireland to be clear that no level of alcohol is safe to drink in pregnancy.

Previously it was recommended that for women who had opted to drink, consuming no more than one or two units of alcohol – equivalent to one or two small glasses of wine – would “minimise the risk to your baby”.

The new guidance says that for women who do drink that amount the risk to their baby is likely to be low, but “nevertheless, we cannot rule out the risks altogether”.

Wren

I can tell you from experience that 10 years ago the NHS pregnancy guide given out specifically said no alcohol should be consumed in pregnancy. I may even be able to find mine from that time, but I’m not going looking in the middle of the night.

The official guidelines have changed, but as your own quote earlier showed, the guidance to limit alcohol to 1-2 units per week has remained.

Sonja Henie

And it is preferable not to drink at all.

Wren

“Preferable”. That’s a value-laden term.

Sonja Henie

STOP IT! WHY is it so necessary for you to defend drinking in pregnancy? You claim you drank little, yet you have been on this topic all day!

Azuran

So have you, why is it so necessary for you to tell women who drank a little that they shouldn’t have?

you think what? That using old English and putting up a ‘urban dictionary’ link is making your argument more valuable?

Wren

Yes, she really does.

LaMont

Once again, to be “that guy,” the “eth” ending on verbs only goes with third person singular, while “thou” takes “est” verb endings. The real quote, then, would never actually be “you doth” but “thou dost”. I normally wouldn’t mind but when someone is trying to condescend and then flubs their Shakespeare, that annoys me on two levels. Also this one is a typical misquote/quote-out-of-context anyway, and thus already on my Shakespeare-quote-shit-list.

Wren

For the same reason Barzini’s “aluminum is a neurotoxin!” and Anna Perch’s “breastfeeding is always the best option” annoyed me.

Sonja Henie

Well, I figured you’d come up with another slam.

Wren

Slam?

You asked. I answered. No slam. Simply examples given as you apparently failed to understand the first time you asked and I answered.

Wren

Just so we are clear, I am under no obligation to “STOP IT!” at your command. You are capable of not responding, are you not?

Sonja Henie

Don’t break your neck falling off your high horse. You’re certainly very adamant about defending drinking during pregnancy, which maybe says more than you think.

Wren

It says I really hate claims that aren’t supported by evidence, regardless of the claim.

Wren

If you like, you can keep trying to imply I must have been a drunk all the way through pregnancy. If I was, my kids got mighty lucky as both are healthy, athletic, smart and generally well-behaved kids. You could try implying that I’m lying about my kids, but I am pretty sure that would put you squarely in the nasty category and it still would not be evidence for your claims.

Wren

All day?

I’ve been to both of my children’s football matches, bought new plants for my aquarium, ate dinner with my family, then went out to see the new Bridget Jones movie with friends.

Amazing that I could do that if I’ve been here all day.

Sonja Henie

Here is the information from 2006: http://www.drfogarty.co.uk/mat_alcohol.pdf
“Based on the best evidence to date, the Royal College of Obstetricians and Gynaecologists recommends that the only way to be absolutely certain that your baby is not harmed by alcohol is not to drink at all during pregnancy or while you are trying for a baby.
If you do drink, you should: ● not drink more than a safe amount, which is defined as not more than one or two units, not more than once or twice per week (see section ‘How is alcohol measured?’) ● avoid binge drinking (see section on ‘What is binge drinking?’) and becoming drunk.”

Wren

Do you understand that many bodies give guidance in the UK? Whether it was because I did not report a history of heavy drinking, they ran out in my area or whatever else, I was never given that specific booklet during either of my pregnancies. The information I was given recommended avoiding alcohol altogether. I know there were concerns about the paternalistic approach from my work in the antenatal clinic a few years before I became pregnant, so I was surprised it had remained. The NHS website now recommends avoiding alcohol but adds the low limit if one chooses to drink.

The NHS has also faced an increasingly litigious public which may have lead to the inclusion of the statement that no level is safe simply to head off claims from women who had children with problems after drinking in pregnancy.

Aluminum is a neurotoxin and dose does not matter!
Alcohol in pregnancy causes FAS and dose does not matter!

Wren

Just FYI, I’m well enough educated that I do not need an urban dictionary definition of a commonly quoted, centuries old phrase. I do find it funny you chose urban dictionary as though it is a valuable source though.

Wren

Even in France women can be alcoholics and drink a whole lot more than the glass here and there mentioned in the sentence just before.

High alcohol intake is causally associated with FAS. 1-2 glasses over a pregnancy, or even 1 a week, has not been causally associated. I have never seen a study claiming evidence that a unit or two of alcohol caused FAS.

Sonja Henie

Methinks you doth protest too much.

Sonja Henie

And you’ve never seen one that says it can’t, either. You seem to feel very strongly about this, I’ll say.

Wren

As do you. Why is it a problem if it is acknowledged that a glass or two during pregnancy has never been shown to lead to FAS?

I feel strongly about this because I don’t like people making claims that are not based on evidence. You have repeatedly made claims that you have not supported with evidence, just as Barzini did with aluminum.

I have seen (as have you if you have bothered to follow links) studies that show no evidence of damage in 5 year olds whose mothers admitted to light to moderate drinking in pregnancy. I have also seen recommendations to avoid alcohol in pregnancy that include advice that light drinking, as defined in the recommendation, has not been linked to problems like FAS.

No, it has never been proven that a couple of glasses through a pregnancy cannot cause FAS, but neither has it been proven that aluminum containing vaccines cannot cause Alzheimer’s. Science doesn’t prove negatives.

Sonja Henie

“Why is it a problem if it is acknowledged that a glass or two during pregnancy has never been shown to lead to FAS?”

Because we don’t know that. You can always find a study to support what you want.

Comparing me to Barzini is a low blow. I would have expected than that of you.

Azuran

Well, your argument is basically the same: that because we don’t know the absolute minimum safe limit, then no amount should be considered safe, even if no harm was ever seen from it.

Sonja Henie

Well, yes.

Azuran

So….are you for or against the hep B vaccine? You know, since we don’t know the minimum safe limit of aluminum in a newborn.

Sonja Henie

Knock it off! There’s no safe limit for teratogens. The hep B vaccine is given to an already born child.

Azuran

Weird, because apparently Vit A is also a teratogens. And there is some of it in my prenatal vitamins.
Or could it be that dose matter and there CAN be a safe limit for something that is teratogenic?

Wren

Did you post about vitamin A first or me? I was commenting and reading Sonja’s responses from the notification page while honestly looking for a teratogen that does not show any threshold effect, so I hadn’t seen this until just now.

Wren

So what makes it a cheap shot to compare your arguments then?

Sonja Henie

Oh, not you again! It’s funny, you blame me for “following” you, say I could have cut it off when you went somewhere, blah, blah, blah, blame me for continuing this, then you post this needling remark.

Wren

If you cannot actually answer the question, maybe you should reconsider your stance.

Wren

I asked an honest question. If your argument is the same as Barzini’s, what is wrong about comparing the two?

Wren

You would have expected that of me? Oh my. Should that make me cry?

You followed me around upvoting every comment I made to him. The minute I disagree with you, I’m a nasty, terrible person though, right?

“You can always find a study to show whatever you want”? Really? A leaf taken straight from the pseudoscience handbook.

You have no evidence a glass or two over the course of a pregnancy is harmful. You cannot simply assert it is harmful without evidence. You are behaving like the anti-vaxers who need proof of absence of harm. You are behaving like the lactivists who assert risks from properly made and dispensed formula in healthy, full term infants in developed countries. You are behaving like the NCBers who assert c-sections, lights, monitoring and hats all cause harm.

No one here, me included, has argued that drinking in pregnancy is recommended. No one, me included, has argued that moderate to heavy drinking causes no harm.

Sonja Henie

Well I’ll go back and remove all my upvotes, If that’s what you want. “Followed you around” my derriere! Maybe YOU were following me around? Oh, no, you’re the “better person”, aren’t you?

You don’t get the difference, that alcohol is a teratogen Now you’re calling me names. Well, actually, you started that with that Barzini business.

Nasty might not have been the right word earlier today, in fact I was going to say it was more like a cluster-****. But it sure applies now. I’m Barzini, I’m a psuedo-scientist. I’m an anti-vaxer, I’m and NBCer. What else do you want to call me?

Wren

You are still one of my followers on disqus. Yep, followed me around.

Try reading again, because I never said you were any of those things.

Sonja Henie

So what if I follow you on Disqus? I want to see what people are talking about. It doesn’t necessarily mean I like them. And you sure are interested in carrying on this cat-fight.

Wren

I’m up because I can’t sleep due to a chest infection. I really don’t care. You could have backed off hours ago, while I was at the cinema, but you have stubbornly stuck to you non-evidenced claim that any alcohol passing the lips of a pregnant woman is harmful.

Just wondering, does communion wine count? I’m betting a whole lot of pregnant women have communion wine at least weekly throughout their pregnancy, and some may well do far more often.

Sonja Henie

Yeah, this is all my fault.

Wren

You chose to pursue this for hours, without evidence.

TheArtistFormerlyKnownAsYoya

So what? I’ve never seen a study saying exposure to sunlight in pregnancy doesn’t cause autism either. So we should all just avoid sunlight in pregnancy!

Sonja Henie

You know, I know that people who drink a lot go to great lengths to defend said drinking.

You’re being ridiculous and you probably know it. There’s no Fetal Sunlight Syndrome that I’m aware of. Could you publish a cite or two please?

TheArtistFormerlyKnownAsYoya

You’ve established that you believe anyone defending the lack of evidence of any harm done by light to moderate drinking in pregnancy clearly must have a problem with alcohol. I’m not sure anyone else here is buying that.

As for my point that you missed, it seems that purposely missing the point has become your debate tactic. If you pretend not to understand, others will eventually just give up trying to explain.

Wren

No evidence still, so just implying anyone who disagrees with you is a drunk who could not avoid alcohol while pregnant?

Wren

And you complained that I was on here all day?

Unless you actually have some evidence, you really ought to let this one go. You really are sounding like Barzini and co with your “we don’t know the safe limit”. We have not studied it down to the drop, but we are fairly confident it is someplace above one or two glasses over 9 months. Every study

Azuran

There is not a ‘known safe level’ because testing on pregnant women in unethical. Figuring out a ‘safe level’ would require making thousands of pregnant woman drink various amounts of alcohol during pregnancy and see at how much alcohol babies can start having FAS. We just don’t do that.
There is a difference between ‘it’s known to be dangerous’ and ‘We haven’t tested it’
FAS happens in women who drink a lot, even even then, many alcoholic mothers have totally normal babies. No baby was ever born with FAS because their mom drank 1-2 glasses a month during pregnancy.

Sonja Henie

” No baby was ever born with FAS because their mom drank 1-2 glasses a month during pregnancy.”

And you know this how? I agree it’s unlikely, but that’s a pretty bold statement.

demodocus

We don’t of course. One would think the percentage of people with it would be higher, though, if 1-a-month habit gave a significant risk.
On a side note, do you also recommend against alcohol consumption when breastfeeding, because i ran across a lot of people recommending beer to help with supply.
ETA: I’m a natural teetotaller, so this is academic to me.

“The American Academy of Pediatrics (AAP) recommends that nursing moms avoid alcohol with the possible exception of the occasional small drink. The AAP also suggests waiting two hours to breastfeed after having a drink. (The alcohol will clear from your breast milk just as it clears from your bloodstream.)”

Azuran

If we based pregnant mother’s acceptable behaviour on ‘what has been proven to be safe if you do it 1-2 per months) we wouldn’t be allowed to do or eat anything.
I base this assumption on the fact that it has never been reported for a baby to be born with FAS when the mother drank 1-2 glasses a month while pregnant.

Sonja Henie

I take it you are a FAS researcher then to “know” this fact.

Azuran

You have case report of a baby with FAS after the mother drank 1-2 per month?

Sonja Henie

I’m not an FAS researcher. You made the claim, yours to support!

Wren

You made the claim that it wasn’t safe.

Sonja Henie

Good God, what’s happening on this board? People you once thought were nice, turn out to be nasty! Of course I said alcohol isn’t safe in pregnancy. That is in line with every health agency in the entire WORLD. Azuran is the one who made the claim that “No baby was ever born with FAS because their mom drank 1-2 glasses a month during pregnancy.” How does s/he know that? That’s what I was asking of him/her. If you can’t substantiate a claim, maybe you shouldn’t be making it1

Mike Stevens

It does seem biologically implausible that a very low intake of alcohol could cause FAS, because it seems very rare in women who have had low alcohol intake in pregnancy. The concern would be that even low levels of alcohol in a woman with predispositions to having babies affected (such as smokers) might have some neurological impact and contribute to fetal alcohol spectrum disorder of some minor degree.

PS: analogies to anything else we usually discuss?

Sonja Henie

I agree that it seems implausible. I actually said that last night, but none of the people on here who want to justify their own drinking during pregnancy will acknowledge that.

The problem is, if you say it’s OK to drink “once in a while” the HCP may have one idea about what that is, and the patient may have another idea altogether. There are things you can say to a group of friends sitting around the table that you shouldn’t say as public policy. That goes for immunizations as well.

Wren

Exactly why the UK changed their advice. They moved from paternalistic guidelines that assume pregnant women are unable to understand what level of drinking is likely to cause harm to a guideline that clearly outlines an acceptable level of 1-2 units per week. Units of alcohol are clearly defined as well.

I don’t feel the need to justify the total of 1 1/2 glasses of champagne over two pregnancies. It caused no harm and it is biologically implausible that it ever could have. My severe morning sickness over the full term each time had far greater potential to cause harm.

Sarah

You should take your own advice then.

You said that alcohol isn’t safe in pregnancy, but you cannot prove this to be true. Quoting various bodies who state we don’t know what the safe level is or whether there is one and as such it is better to abstain/drink minimally is not evidence of this. It is simply evidence that we don’t know and recommendations are made with this in mind.

Sonja Henie

I surer than H*ll can prove that alcohol isn’t safe in pregnancy.http://pubs.niaaa.nih.gov/publications/arh25-3/168-174.htm
“Because no threshold for alcohol s detrimental effects on the developing fetal brain has been established, women should cease to consume alcohol immediately upon learning that they are pregnant”

There are literally hundreds of such studies.

Wren

That does not prove alcohol is not safe in pregnancy. What it proves is that we currently do not know what the minimum level that causes injury is.

We actually have fairly good evidence that a drink once a week does not cause noticeable harm.

Just in case you didn’t realise it, your link refers to children with “heavy prenatal alcohol exposure”, not children whose mothers had any amount of alcohol during pregnancy.

Sonja Henie

Try this then. And you really do protest too much.http://www.come-over.to/FAS/alcohol.html
“Alcohol is a teratogen. There has been no teratogenic agent yet studied in man which has shown a clear threshold effect, i.e. where the substance couldbe considered safe at a particular level, beyond which its teratogenic effectbegins to take hold, and alcohol is no exception.”

There are a lot of references in this article, 124 to be exact. Now please stop this hijack. We know you wish to defend drinking in pregnancy and nothing I show will change your mind.

Wren

Your teratogen claim here is simply untrue. A threshold effect is commonly seen. In fact, specific genes are studied for their impact on the threshold effect of some teratogens.

“1. Do human clinical studies or epidemiological studies consistently
support the concept that high doses of vitamin A may be teratogenic
and produce a recognizable group of malformations?

No human epidemiologic studies are available. Although not conclusive, the case reports suggest that high doses of vitamin A may be teratogenic, since some of the infants had malformations that fit the recognizable pattern that occurred following human exposure to isotretinoin.”

There are plenty of other studies, textbooks and even recommendations that describe vitamin A as teratogenic in high doses. If it makes you happy, you can always believe it isn’t.

Just to be clear, what is that “recognisable pattern that occurred following human exposure to isotretinoin”?

Wren

And did you happen to notice that a “lowest teratogenic dose” for humans was given for isotretinoin and etretinate in this paper? Pretty conclusive evidence that a threshold effect is seen in at least some teratogens.

Ionising radiation is another teratogen in which the threshold effect is well studied, due to exposure for medical testing.

Sonja Henie

Why is it untrue? I posted a cite that says it is! Of course, I’m a “psuedo-scientist” now.

Wren

It is untrue because that is not one of the characteristics of a teratogen. Some may have no threshold, though I cannot think of an example offhand. It is definitely not true of all teratogens though.

Wren

Just so you do not accuse me of asserting without evidence at your teratogens have no threshold claim is untrue, I submit vitamin A. It is required in the human body, but an excessive dose in pregnancy is a teratogen.

I am not including a link, but a very simple search will show this to be true.

Sonja Henie

You’re not including a link because you don’t have one. Your assertion, you prove it.

Wren

Done. A simple search would have shown it to be true, but again with the pseudoscience behaviour, expecting to be spoon-fed info even after being told where to look for it.

Sonja Henie

And you just said you didn’t call me names.

Wren

No, I identified the behaviour.

Here’s an example: saying that someone is stupid is not the same as saying that someone did something stupid. The first is name calling, while the second is identifying the behaviour. Plenty of smart people do stupid things at times.

Sonja Henie

Oh, get off you high horse.

Wren

Again?

That particular comment is now just getting ridiculous. If you feel you must respond, you. could at least try using a response that you haven’t already used.

Sarah

No, you can’t. That is not proof of what you say it is. It is proof that we don’t know if there is a safe threshold and, if there is one, what it is, and as such that most bodies advise none or only minimal consumption. That is what the words used mean. It proves my point, not yours.

Wren

Not agreeing with you is not being nasty.

You are absolutely insistent, without evidence, that any level of alcohol consumption in pregnancy will cause harm. When questioned, you point to recommendations but not to studies that would actually be evidence for your claim.

Azuran questioned your claim, that you have yet to provide evidence for. Again, those recommendations are not evidence that any amount of alcohol is definitely harmful, but some studies have shown light to moderate drinking in pregnancy not leading to harm.

Azuran

Seriously, how should I go and prove it to you? How many hours should I spend looking around pubmed and other resources without any results before you are satisfied that there are no such cases?
I have no time to waste trying to prove a negative to you. You don’t want to drink while pregnant, go you. I personally don’t either, but I also know that a few glasses here and there will cause no harm to a baby and does not judge people who drink responsibly even while pregnant.

Sonja Henie

I really don’t need or even want any proof. But you don’t know that what you’re saying is true.

Azuran

Really, we don’t know the safe level of basically anything, pregnancy is a whole lot of: Don’t do that, it hasn’t been proven that it’s 100% safe in every possible circumstances.
And it gets freaking annoying to have people measure your worth as a future mother by how much of everything fun in life you stop doing while pregnant.

Sonja Henie

“And it gets freaking annoying to have people measure your worth as a
future mother by how much of everything fun in life you stop doing while
pregnant.”

And even if it did, at least it only harms said mother’s developing baby. Not like refusing to get your kid vaccinated.

Andrew Lazarus

When my mother didn’t seem to be gaining much weight in pregnancy, the OBGYN recommended one beer a day. Times changed. But the dose makes the poison.

Sonja Henie

But we don’t know the lowest safe dose.

Andrew Lazarus

We don’t know the highest safe dose for spinach, either, but we can be pretty sure it’s way higher than a spinach salad. The problem is that, unlike spinach, there are people who are unable to control their alcohol use without serious external pressure. Some of them, when pregnant, will drink heavily anyway, with increased risk for FAS. But some of them will go on the wagon, at least for the duration. And the whole no-drinking-when-pregnant campaign seems, frankly, to be aimed at that subgroup; the woman who had a drink a week is just swept up in it.

Sonja Henie

Spinach is not a known teratogen, either. The best advice is still “abstain”. But I’m not going down that rabbit hole again.

“Low to Moderate Alcohol Use During Pregnancy and the Risk of Specific Neurodevelopmental Effects in Five Year-Old Children

The Lifestyle During Pregnancy Study examined a subset of five-year-old children and their mothers from the Danish National Birth Cohort. The study investigated three neurodevelopmental effects in five-year-old children whose mothers reported drinking low to moderate amounts of alcohol* during pregnancy. The purposes of this study, funded in part by CDC through a cooperative agreement, were to (1) gain a better understanding of how different amounts of alcohol can affect child development, (2) improve study methods to better understand the less obvious effects of low to moderate prenatal alcohol use, and (3) address some of the challenges with measuring subtle effects of drinking alcohol on neurodevelopment.”

Maud Pie

This is an area where I take the better-safe-than-sorry approach. I agree that the risk is very low for one drink here and there, but it’s hard to translate that to a specific safe quantity. On the cost side of the analysis, 9 months of abstaining from alcohol is virtually nil. (Unless you have an addiction issue, in which case you have a more urgent problem than determining a safe level of consumption.). So I agree that the most prudent recommendation is to completely abstain, and failing that, some level lower than the lowest level considered safe. For me, that was one glass of wine in the 7th month.

demodocus

For me it was making 1 pot of beef burgandy last February.

Wren

I generally took the better safe than sorry approach too.I was informed of the risks and treated like an adult with a brain who could make my own decision despite being pregnant sometimes. Other times I had experiences like my stepfather deciding I would be served non-alcoholic sparkling cider at my sister’s wedding for the toast rather than champagne without asking me and being told I should not be drinking in my condition when I bought some wine for my husband.

TheArtistFormerlyKnownAsYoya

The tales of nosy shopkeepers assuming a pregnant woman is buying alcohol for herself always baffle me. Because pregnant women never buy alcohol for their husbands, or throw dinner parties, or anything…

Wren

Nope. We all just guzzle it down non-stop.

Heidi_storage

I was a bit embarrassed to be taking my three-year-old, nineteen-month-old, and visibly pregnant self to the liquor store to buy some brandy (for cooking), but the clerk was very nice and chatted to me only about how cute my kids were and how his daughter was expecting her fourth. People aren’t ALWAYS senselessly judgmental.

TheArtistFormerlyKnownAsYoya

I haven’t had anyone say anything to me either, but you hear these stories floating around. Personally I think you shouldn’t even feel embarrassed in that situation, you’re doing nothing wrong! We’ve created a certain culture around pregnancy and alcohol (or pregnancy and caffeine, or deli meat, or whatever…) such that sometimes perfect strangers feel they have the right to question what you’re doing when you’re minding your own business. It perplexes me sometimes the assumptions they must be making.

guest

With alcohol, this may be simple. But the restrictions go far beyond that. I read restrictions that included canned foods, which would have been a huge burden to me. I can’t afford to eat out/have someone else cook for me, but I would also get so hangry and tired while pregnant that canned tomatoes and green beans and the like were important way for me to eat vegetables without always having to cook from scratch. The restriction of cold cuts made lunches at work difficult (no access to kitchen at work other than a dirty microwave, no nearby restaurants) without also spending a great deal of time preparing the night before…when I was exhausted and wanted to sleep. If I’d followed the restriction on caffeine I would have been even crankier and less able to make healthy food choices as a result.

Meanwhile, while I was pregnant there was an outbreak of Listeria linked to canteloupe, yet no one issued an advisory that pregnant women should avoid melon.

Amy Tuteur, MD

There seems to be a genetic predisposition involved as well. FAS is very rare in Europe, much more common in the US and very common in Russia.

Another interesting finding: there was a case report from Denmark of an alcoholic mother giving birth to twins; one was affected with FAS and the other was not.

Sonja Henie

I also think that the differences in reported rates in the US may have a factor like the differences in infant mortality rates between countries, that is, a different way of reporting. White Americans have European ancestors, most of whom are not Russian.

Read more then. In the UK the advice was none at all until quite recently, NICE now says avoid or no more than 1-2 units a week. That is, a liberalisation in the recommendations. Not something that is becoming less acceptable. The UK is somewhere, so no, not everywhere.

Sonja Henie

Actually, here is the UK’s advice (from my link, above):
“The Chief Medical Officers’ guideline is that: If you are pregnant, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum. Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink the greater the risk. The risk of harm to the baby is likely to be low if you have drunk only small amounts of alcohol before you knew you were pregnant or during pregnancy. If you find out you are pregnant after you have drunk alcohol during early pregnancy, you should avoid further drinking. You should be aware that it is unlikely in most cases that your baby has been affected. If you are worried about alcohol use during pregnancy do talk to your doctor or
midwife.

Alcohol and Pregnancy: Information for You: If you choose to drink, to minimize the risk to your baby, don’t drink more than 1-2 units of alcohol – that’s the same as a small glass of wine – once or twice a week. And don’t get drunk. Use the Change4Life drinks checker to find out how many units of alcohol are in the most common drinks. ”

So preferably, not at all, if you chooseto do so, no more than that.

Sarah

You seem to have missed the point, which is that the guidance is more liberal than it previously was (and even if it weren’t, posting something from the Chief Medical Officer is not a refutation to a point about NICE guidance: there is more than one official source of health advice in the UK). You are therefore not correct about trends everywhere.

MaineJen

There needs to be more nuance, I think…there’s a world of difference between binge drinking in the 1st-2nd trimester and having a glass of wine with dinner when you’re 8-9 months. One is clearly not okay, the other is probably fine.

Wren

Honestly, that’s a nice clear way of putting the point I was clearly failing to explain to Sonja.

Nuance is important.

guest

I had a half a glass of champagne toward the end of my second trimester at a relative’s wedding, and a shot of liquor on New Year’s Eve at the end of the third trimester (four days later, the kids were born).

guest

I got so annoyed with the restrictions in the US that I made a checklist and did a lot of the verboten things (within reason – no cocaine!) in small amounts. Soft cheeses? You bet! Hot baths? You better believe it! (I did keep an eye on the temperature of the bath.) Etc.

Bombshellrisa

Some providers also warn against soft serve ice cream and hot dogs (listeria)

guest

Yes, I forgot about those. I think I skipped them because I don’t care for them anyway, but my list was quite long.

Heidi

I never heard of the stillbirth thing, but from I’ve read, the correlation is probably backwards. Women who can’t stand the thought of coffee during the first trimester are more likely to have viable pregnancies and women who didn’t have any N/V were more likely to already have had pregnancies that weren’t viable because there is some correlation between morning sickness and viability. Of course, I say that knowing plenty of women had N/V and went on to miscarry and plenty of women had unicorn pregnancies. I couldn’t stand the thought of coffee in the beginning so once I could stand it, it took less to get that wakey effect but I never stressed about how much I had and I definitely still had it! I also had artificial sweeteners and evidently the pregnancy police say I shouldn’t do that because you know, no one has done studies specifically on pregnant women. Well, so? I don’t think they’ve specifically done studies on pregnant women and the safety of kale either, have they?

corblimeybot

The morning sickness/viability thing has always been interesting to me. I didn’t have any morning sickness, and later I had a ton of pregnancy complications. Could quite possible be totally unrelated, but it sometimes makes me wonder.

Old Lady

I read about that and worried over the fact that I didn’t experience much morning sickness my first pregnancy. I thought it meant I was likely to miscarry. No problems though, it was an easy pregnancy and babies healthy and big. As easy as being pregnant with twins would be anyway.

guest

My mother apparently had no morning sickness at all. She had two unremarkable pregnancies and two vaginal births. I had one twin pregnancy with just a touch of morning sickness – I figure I take after her. She never had twins, and supposedly multiple gestations correlate with more severe morning sickness. I also had first trimester coffee aversion.

Mariana

Had no morning sickness… Just some food aversion on the first trimester, and two unicorn pregnancies that thankfully produced 2 healthy babies.

Erin

Everyone I know who had/has morning sickness also had horrible travel sickness as kids.

I get awful nausea, not so much vomiting as retching, lots of saliva and the feeling that I’m going to be sick without actually being sick. Can’t wait for it to stop.

Apart from my son getting stuck I had zero complications with my first pregnancy. So far as good with this one too.

N

I had horrible morning sickness, that lasted 24h/day for more than 20 weeks with all those who lived, and a lot of food aversions. With N°3 for weeks I survived on sparkling water and potato chips. The two pregnancies I lost around 12th week, sickness was far less. And I never ever had travel sickness as a kid. Not in a car, nor in a bus or train or plane or ship or whatever. But interestingly since I had a training for my eyes to focus better a couple of years ago, I experience sickness while reading in the bus.

Pregnancies for those who lived were otherwise uncomplicated and birth was C-sections because of breech position (N°1), Baby not finding the exit (N°2), Baby in a diagonal position AND 2 previous C-sections (N°3)

Wren

I did (and still do) have travel sickness and I had awful morning sickness, as in 24 hours a day from 5-6 weeks until the day I went into labour both times.

However, one of my closest friends has never had the tiniest hint of morning sickness and did have travel sickness.

corblimeybot

Hmm, that’s interesting. I actually had pretty bad travel sickness as a kid. People’s bodies are so weird and different.

BeatriceC

I had a horrible aversion to coffee in my first trimester for every pregnancy. It was so bad I couldn’t even have the grounds in the house. That sorted itself out around 13-14 weeks. It was that way for all of my pregnancies; the ones I lost (18w with twins and 16w with a singleton), and the ones that produced a premature, but surviving baby (36, 32, and 24 weeks).

corblimeybot

That kind of reminds me of my husband’s teenage ,childless coworker who tried to tell him that we were fuck-ups for giving up on cloth diapers. Thanks for your totally uninformed opinion, genius.

Mariana

Or a childless friend who asked me why people got so tired taking care of a baby… How hard could it be? It drinks 3 bottles a day (breakfast, lunch and dinner) and sleeps all the time in between (Newborns sleep 18 hours a day, right?). Imagine her shock when I told her they have more like 12 bottles or that many nursing sessions, then it takes time to burp them and change and get them to nap. And that sometimes I didn’t have time to get a proper lunch…

guest

I cut back from four cups to two a day while pregnant, but there was no way in hell I was going to zero.

Mrs.Katt the Cat

I only drink coffee during pumpkin spice season. Last year (while preggo) I had part of one cup. Made my heart race, dizzy, lightheaded. Me being me went ‘that was bad, i wonder if it is this coffee I dont normally drink? Siiiiiip. . , yes, yes it is.”
*sings happily* makin’ up for last year now! Zing! No sleep for me!

Michael McCarthy

“I only drink coffee during pumpkin spice season.”
But, but there’s no pumpkin in a pumpkin spice latte.
(Gawd the foodbabe is a moron)

TheArtistFormerlyKnownAsYoya

Oh, don’t you know? Your uterus is public property.
I’m pregnant as well and loooooving the unsolicitated (uneducated) advice!

BeatriceC

Somewhat off topic: I’m going to have to step away from the troll on the Jack Newman post. I thank all of you who are responding to the troll. I just can’t. I have issues with confrontation and anxiety, and I need to reserve my mental strength for other things right now. I can’t even read it anymore; at least not right now. I wish I could respond so that lurkers could see the truth, but it’s just not in me right now.

niteseer

Take your time, Beatrice. You give valuable input on many threads. Save yourself for the times you can have the most effect. Some people are just lost causes.

BeatriceC

Thanks. I do agree with the sentiment that it’s important to debunk the falsehoods that are presented for the benefit of any lurkers, but I’m just not usually capable. I did engage this time, though I usually don’t. I’ve reached my limit this time around. I did better than I usually do, so there’s hope for me yet.

demodocus

i think i like the ones from The Hobbit more

BeatriceC

Or the ones from Harry Potter.

MaineJen

Troooooooll in the dungeon! <– Should that be our new battle cry?

demodocus

I’m kinda dying to use this one.

MI Dawn

I gave up on that one. She’s just too dense and I couldn’t deal with the elevated blood pressure she gave me.

Maud Pie

Me too. I’m taking a week’s vacation starting Sunday and I’m making it a vacation from youknowwho as well.

The events of that thread have started an ear worm:

You keep lying when you oughta be truthing
And you keep losing when you oughta not bet
You keep saming when you oughta be a-changin’
What’s right is right but you ain’t been right yet

These boots are made for walking…

MaineJen

Grabs popcorn, waits for anti-vaxxers’ heads to explode

Amy M

That’s interesting. When I saw the headline, I began thinking about it—maybe another way vaccines could help reduce abx resistance is by preventing secondary infections? For example, developing pneumonia after measles is possibility, so preventing measles is also preventing a case of pneumonia. It’s pretty indirect, and can be argued that not all pneumonias are bacterial, and abx won’t help viral pneumonia infections. And again, with the measles vaccine–I read that a person who gets measles will have a weakened immune system and be more vulnerable to infections (including bacterial) for some years after.

And let’s not forget, for example, that strep pneumoniae causes some ear infections, even aside from causing pneumonia, so there’s the benefit of kids missing less school for “minor illness” too.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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